Morphometric study of the deep femoral artery in patients with and without total occlusion of the superficial femoral artery

The profunda femoral or deep femoral artery physiologically supplies the tissue of the thigh. The profunda femoris artery is recog-nized the most important collateral vessel for bypassing the obstructed superficial femoral artery and is essential for maintaining limb viability.This paper shows the situation of the artery profunda femoris with superficial artery occlusion, with specific reference to the mor-phometric angiographic manifestations produced by impaired hemodynamics in the lower extremity. The morphologic and mor-phometric characteristics of profunda femoral artery are studied as expression of possible hemodynamic compensation through the hypertrophy of the vessel in the situation of occlusion of superficial femoral artery. This paper show, the situation of the artery profunda femoris with superficial artery occlusion, with specific reference to the mor-phometric angiographic manifestations produced by impaired homodynamic in the lower extremity. The morphologic and morpho-metric characteristics are studied as expression of physiopathology's characteristics of the profunda femoris artery with occlusion of the superficial femoral

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Elena Céspedes. La asombrosa historia de una mujer que ejerció de cirujana como varón / Elena Céspedes. The amazing history of a woman who exercises surgeon as a man

A lo largo de la historia se puede considerar que no han sido muchas las mujeres que han podido ejercer como cirujanas en las diferentes civilizaciones y cuando esto ha sido posible en muchos casos han tenido que hacerlo disfrazadas de nombre. El caso de Elena de Céspedes se puede considerar peculiar en primer lugar por su situación biológica de posible hemafroditismo, a lo que se añade su vida venturera ejerciendo múltiples oficios incluido el de soldado hasta llegar a la de médico cirujana que ejerce como varón. El descubrimiento de esta situación la hace que sea acusada de diferentes delitos y al final juzgada por la Inquisición siendo condenada. Resalta en su personalidad su reconocida inteligencia que la hace progresar desde el punto de vista social desde su inicio como esclava hasta lograr acreditarse como cirujano y cirujano sangrador logrando ejercer el oficio con solvencia y maestría. Se la considera referencia como mujer cirujano en la historia de la medicina

Throughout history it can be considered that there have not been many women who have been able to practice as surgeons in diffe-rent civilizations and when this has been possible in many cases they have had to do it disguised as a name. The case of Elena de Céspedes can be considered peculiar in the first place due to her biological situation of possible hemaphroditism, to which is added her life as a trainee exercising multiple trades, including that of a soldier until she becomes a surgeon practicing as a male. The discovery of this situation causes her to be accused of different crimes and in the end judged by the Inquisition to be condemned. Her personality stands out in her well-known intelligence, which makes her progress from the social point of view from her beginning as a slave to becoming accredited as a bleeding surgeon and surgeon, achieving the job with solvency and mastery. It is considered a reference as a female surgeon in the history of medicine

Barley Stripe Rust Resistance QTL: Development and Validation of SNP Markers for Resistance to Puccinia striiformis f. sp. hordei.

Quantitative trait loci (QTL) for barley stripe rust resistance were mapped in recombinant inbred lines (RIL) from a 'Lenetah' × 'Grannelose Zweizeilige' (GZ) cross. GZ is known for a major seedling resistance QTL on chromosome 4H but linked markers suitable for marker-assisted selection have not been developed. This study identified the 4H QTL (log of the likelihood [LOD] = 15.94 at 97.19 centimorgans [cM]), and additional QTL on chromosomes 4H and 6H (LOD = 5.39 at 72.7 cM and 4.24 at 34.46 cM, respectively). A QTL on chromosome 7H (LOD = 2.04 at 81.07 cM) was suggested. All resistance alleles were derived from GZ. Evaluations of adult plant response in Corvallis, OR in 2013 and 2015 provided evidence of QTL at the same positions. However, the minor QTL on 4H was not statistically significant in either location/year, while the 7H QTL was significant in both. The single-nucleotide polymorphism markers flanking the resistance QTL were validated in RIL from a '95SR316A' × GZ cross for their ability to predict seedling resistance. In 95SR316A × GZ, 91 to 92% of RIL with GZ alleles at the major 4H QTL and at least one other were resistant to moderate in reaction. In these populations, at least two QTL were required to transfer the barley stripe rust resistance from GZ.

Tumor del cuerpo carotídeo en paciente joven / Carotid body tumour in young patient

Se presenta por los autores un caso de tumor carotídeo desarrollado en una joven. Se realiza una revisión sobre el manejo de este tipo de patología y se discute las características del caso con la información disponible en la bibliografía

The authors present a case of Carotid body tumor in a young women. A review of carotid body tumour management is made and have the discussion with the characteristics of the case in comparition of the information of the bibliography

Stent carotídeo. Revisión y puesta al día / Carotid stenting. Review of the evidence

INTRODUCCIÓN. En el momento actual no existe un total acuerdo sobre el tratamiento de elección en la estenosis carotidea, las dos opciones terapéuticas existentes son la tromboendarterectomia (TEA) carotidea y el stent carotideo. En esta revisión hemos querido analizar los resultados de los estudios publicados en los últimos años y la evidencia científica existente en la actualidad. MATERIAL Y MÉTODOS. Se realizó una búsqueda bibliográfica de la Nacional Library of Medicine (PubMed). Las palabras clave introducidas para realizar dicha búsqueda fueron carotid stenosis, stent, y thrombo endarterectomy. Se incluyeron los trabajos publicados desde 2006 hasta 2008, en inglés y español. RESULTADOS. Con los límites citados anteriormente se encontraron 225 artículos y 24 revisiones, de los cuales eran referentes al tema 14 de ellos. CONCLUSIONES. Los datos son difíciles de interpretar porque los ensayos son heterogéneos (diferentes pacientes, técnica y duración de seguimiento) y cinco ensayos se interrumpieron anticipadamente por el elevado índice de stroke/muerte del tratamiento endovascular. La evidencia científica sobre el tratamiento de la estenosis carotídea mediante angioplastia/stent, no apoya un cambio en la práctica clínica frente a la tromboendarterectomía carotídea, salvo en grupos seleccionados de pacientes (AU)

INTRODUCTION. In the current moment a total agreement does not exist on the treatment of choice in the carotid stenosis, both therapeutic existing options are carotid thromboendarterectomy and carotid stent. In this review we have wanted to analyze the results of the studies published in the last years and the scientific existing evidence at present. MATERIAL AND METHODS. There was realized a bibliographical search of Native Library of Medicine (PubMed). The key words introduced to realize the above mentioned search were carotid stenosis, stent, and thromboendarterectomy. The articles were included published from2006 until 2008, in English and Spanish. RESULTS. With the limits mentioned previously, we found 225 articles and 24reviews, 14 of them were relating to the topic. CONCLUSION. There are several controversies because the studies are heterogeneous(different patients, technicals and duration of follow-up) and five of them were interrupted early by the high index of stroke/death of the endovascular treatment. The scientific evidence on the treatment of the carotid stenosis by means of angioplasty/stent, does not support a change in the clinical practice opposite to carotid thromboendarterectomy , except in groups of selected patients (AU)

Utilidad y pautas de seguimiento de la revacularización de miembros inferiores: Revisión bibliográfica / Utility and surveillance protocol of lower limbs revascularization: A bibliographic review

INTRODUCCIÓN. Actualmente no existe unanimidad sobre las pautas de seguimiento de la revascularización de miembros inferiores; ni siquiera si ésta resulta útil a medio y largo plazo. La finalidad del trabajo es revisar la bibliografía científica para establecer un protocolo de seguimiento actualizado según las últimas publicaciones. MATERIAL Y MÉTODOS. Se utilizó la base bibliográfica de la Nacional Library of Medicine (PubMed). El estudio se limitó a trabajos publicados en los últimos 10 años en inglés, español que dispusieran de abstract on-line. RESULTADOS. Con dichos parámetros de búsqueda aparecen 124 trabajos de los cuales, 22 de ellos hacen referencia directa o indirecta mientras que los 102 trabajos restantes fueron desechados por no ajustarse a la finalidad de la búsqueda. CONCLUSIONES. Aunque la tasa de amputaciones, permeabilidad y salvamentos a los 18 meses en los pacientes seguidos mediante eco-doppler no difiere significativamente de los pacientes que se incluyen dentro de programas de seguimiento clínico, un estudio ecográfico a las 6 semanas puede predecir la historia natural de un by-pass con vena y así establecer los pacientes que se beneficiarían del seguimiento ecográfico. De ésta forma se reducurían los costes asociados y la tasa de reintervenciones (AU)

INTRODUCTION. At the moment there is no unanimity on the rules of surveillance of the revascularization of lower limbs; not even if this is useful to half and long term. The purpose of the article is to revise the bibliography in order to establish a protocol of follow up modernized according to the last publications. METHODS. The bibliographical base of the National Library Medicine (PubMed) was used. The study was limited to papers published into 10 last years. RESULTS. With this parameters of search 124 entries appear of which, 22 of them makes direct or indirect reference to the purpose while the 102 remaining papers were discarded by not adjusting to the purpose of the search. CONCLUSIONS. Although the rate of amputations, patency and salvages at the 18 months in the followed patients by echo-doppler don't differ significantly of the patients that are included into programs of clinical follow up, a duplex scan sonography at the 6 weeks predicts the natural history of a vein graft and so establish the patients that would benefit from the surveillance by echo-doppler in order to decrease the associate costs and the rate of reinterventions (AU)

Isquema mesentérica. Revisión y puesta al día / Mesenteric ischemia. Review and update

A pesar de los recientes avances que han mejorado los resultados de la mayoría de las patologías quirúrgicas en las últimas décadas, la isquemia mesentérica continúa constituyendo una enfermedad con una elevada morbilidad. Una elevada sospecha clínica, así como el conocimiento de las diferentes posibilidades diagnósticas son esenciales para el correcto tratamiento de estos pacientes. El tipo de tratamiento depende en gran medida de la presentación clínica así como del tiempo de evolución puesto que representa el factor de mayor importancia para determinar la viabilidad intestinal. La angioplastia transluminaly el stent de las arteria viscerales son unas alternativas viables en el tratamiento de la isquemia mesentérica crónica. Revisamos la fisiopatología, la presentación clínica y el estado actual de las técnicas diagnósticas y terapéuticas (AU)

Although recent advances have improved outcomes in most surgical diseases over the last several decades, mesenteric ischemiaremains a highly morbid condition. High clinical suspicious and knowledge of the differential diagnostic possibilities inthis clinical setting are essential for the correct management of this patients. The type of the treatment depends largely on the clinical presentation, with time being the most important factor determining viability before irreversible damage occurs to the bowel. Transluminal angioplasty and stenting of the visceral arteries is a viable alternative for treatment of chronic mesentericischemia. We review the pathophysiology, the clinical presentation and the current state of the art in diagnosis and treatment (AU)

Actualización en diagnóstico y tratamiento de la isquemia aguda en extremidades / Updating diagnosis and treatment in acute limb ischemia

La isquemia aguda de la extremidad es definida como cualquier disminución brusca de la perfusión que cause una posibleamenaza a la viabilidad de la misma. La isquemia aguda de extremidad inferior continua asociada a una alta morbilidady mortalidad a pesar de los avances en los cuidados perioperatorios y en las técnicas de revascularización. En especial lospacientes de edad avanzada están expuestos a un alto riesgo de complicaciones graves tanto locales como sistémicas. Lacomorbilidad, los trastornos metabólicos asociados a la isquemia aguda y el síndrome de reperfusión están asociados a estepobre pronóstico. En este artículo nos proponemos una actualización en el manejo de este tipo de pacientes presentandonovedades en diagnóstico y tratamiento. Para ello hemos realizado una revisión de la literatura publicada en los últimos 5años centrándonos en los trabajos que aportan nuevas herramientas en diagnóstico y tratamiento para reducir la elevadamorbilidad y mortalidad que presentan este tipo de pacientes (AU)

A systematic review of the medical literature was performed for relevant studies. We searched a number of electronic databasesand hand-searched relevant journals since January 2002 until November 2007. We considered studies in which diagnosisand treatment were evaluated to diminish the morbimortality. Isquemia acute of the extremity is defined as any abruptdiminution of the perfusión that causes a possible threat to the viability of the same one. Isquemia acute of continuous inferiorextremity associated to a high morbidity and mortality in spite of the advances in the perioperatorios cares and the techniquesof revascularización. In special the age patients outpost they are exposed to a high risk of local serious complicationsas as much sistémicas. The comorbidity, the metabolic upheavals associated to isquemia acute and the syndrome of reperfusiónare associate to this poor prognosis. In this article we set out an update in the handling of this type of patients presenting/displaying new features in diagnosis and treatment. For it we have made a revision of Literature published in the last5 years having centered in the works that contribute to new tools in diagnosis and treatment to us to reduce the high morbidityand mortality who present/display this type of patients (AU)

Oclusión del bypass infrainguinal / Infrainguinal graft occlusion

La oclusión del bypass infrainguinal puede ocurrir en el periodo postoperatorio inmediato (oclusiones agudas) o años después (oclusiones tardías). La prevención de la oclusión incluye una correcta decisión de intervenir y una adecuada elección del flujo de entrada y salida, lugares de anastomosis proximal y distal y del conducto empleado. Además se encuentran la confirmación intraoperatoria del éxito técnico, la antiagregación postoperatoria, el seguimiento con dúplex, y el cese del hábito tabáquico o el control estricto de los niveles glucémicos. Las oclusiones agudas deben ser tratadas inmediatamente con una esperanza razonable de restaurar la permeabilidad. El pronóstico de los pacientes con oclusiones tardías es pobre, sin embargo, la reoperación electiva con un nuevo bypass de vena autóloga consigue unos porcentajes favorables de salvamiento de extremidad en pacientes con síntomas isquémicos. El propósito de nuestra revisión es aportar un acercamiento a la oclusión del bypass infrainguinal que logre una máxima permeabilidad a largo plazo, salvamiento de extremidad y supervivencia del paciente (AU)

Infrainguinal graft occlusions may occur in the immediate postoperative period (acute occlusions) or years later (late occlusions). Prevention of postoperative graft occlusions includes a correct decision to operate and adequacy inflow and outflow vessels, proximal and distal anastomoses, and conduit. Intraoperative confirmation of technical success, postoperative antiplatelet therapy, follow-up with duplex scanning and smoking cessation or close perioperative glycaemic control, were included in this composite endpoint. Acute occlusions should be treated immediately with a reasonable expectation that patency can be restore. The overall prognosis for patients with late failed infrainguinal grafts is poor however elective reoperation with a new autogenous vein graft achieves favourable limb salvage rates in patients with ischemic symptoms. Aim of our review is provided an approach to graft infrainguinal occlusions that results in maximal long-term graft patency, limb salvage and patient survival (AU)

Detection of QTL linked to Fusarium head blight resistance in Sumai 3-derived North Dakota bread wheat lines.

During the past decade Fusarium head blight (FHB) caused by Fusarium graminearum Schwabe has resulted in severe grain yield and quality losses of wheat (Triticum aestivum L.) in the Northern Great Plains of the U.S. Given the complexity of breeding for FHB resistance, molecular markers associated with this trait will be valuable in accelerating efforts to breed resistant cultivars. The objective of this study was to identify molecular markers linked to quantitative trait loci (QTL) for FHB resistance in wheat using a set of lines obtained by several cycles of crossing to North Dakota adapted genotypes, which derived their resistance from cv. Sumai 3. Microsatellite markers spanning the wheat genome were used to screen parents and derived lines. Polymorphisms for parental alleles were compared to disease scores for Type II resistance. The probability of linkage between markers and introgressed resistance genes was calculated using a binomial probability formula based on the assumption that a molecular marker at a specific distance from the introgressed gene, in a near-isogenic line (NIL), will carry the donor-parent allele as a function of the distance between marker and gene and the number of backcrosses/selfs performed in deriving the NIL. Microsatellite loci Xgwm533 and Xgwm274 were significantly associated with QTL for FHB resistance.